TTHHEE UUNNTTOOLLDD TTRRUUTTHH AABBOOUUTT CCAANNCCEERR he word "cancer" is of Latin derivation and means "crab". Today, cancer "cure" is a vast industry. But by the turn of the 20th century, the medical profession had come to the conclusion that it was not a Tmatter of whether infectious disease caused cancer, but of which one. For over 200 years, a cancer germ had been discovered and rediscovered, named and renamed, each scientist adding to the knowledge but to no avail. The US medical Then, in 1910, certain American medical powers did a 180-degree rotation, deciding that cancer was not caused by a microbe and that anyone who establishment once thought otherwise was a heretic, a charlatan or a quack. accepted a microbial Dr Virginia Wuerthele-Caspe Livingston and her network were none of the above, their meticulous peer-reviewed research and publications produced cause of cancer, at the height of US post–World War II technology. Dr Dean Burk, who co- founded the US National Cancer Institute and headed its cell chemistry but in 1910 it did an department for 34 years, went so far as to say that Livingston's cancer germ about-face and from was as real and certain as anything known about cancer. Researcher Dr Alan Cantwell, Jr, grew up thinking that all germs responsible for the important thereon refused to diseases were supposed to have been discovered already. But much to his accept the validity of dismay, he found one that had been left out: the cancer germ. Cantwell knew that Livingston had already been branded by the medical orthodoxy for scientific studies that finding this cancer germ—thus, what he thought to be perhaps the major discovery of the 20th century was left largely discredited. proved the existence The striking analogy between cancer and tuberculosis (TB) was noticed of a cancer germ. long before the tubercle bacillus was discovered. In 1877, Sir John Simon clearly pointed out the similarity and in fact argued very strongly in favour of a microbial mycobacterial origin for cancer. Since then, literally thousands of articles and texts have shown malignant changes to spring from tuberculous infection. But Sir John's vindication would have to wait for Part 1 of 2 Livingston's germ which, although tuberculosis-like, was not tuberculosis but an atypical form of this mycobacterium, melded from the mycobacterium and other related Actinomycetales. Had medical science, and the powers that be, spent as much time in investigating and destroying Livingston's germ as they did in attacking her and those around her, cancer might be curable today. by Lawrence Broxmeyer, MD Hodgkin's cancer Under attack © 2009 When Virginia Livingston was a student at Bellevue Medical College in The N. Y. Institute of Medical New York City, her pathology teacher mentioned rather disparagingly that Research, New York, USA there was a woman pathologist at Cornell University who thought Hodgkin's 1 Email: nyinstituteofmedical disease (a form of glandular cancer) was caused by fowl tuberculosis. This [email protected] pathologist had published, but no one had confirmed her findings. Website: Afterwards, Livingston compared slides of the two diseases. In Hodgkin's, http://drbroxmeyer.netfirms.com/ the giant multinucleated cells were called Reed–Sternberg cells and were similar to the giant cells of tuberculosis which formed to engulf the tubercle DECEMBER 2009 – JANUARY 2010 www.nexusmagazine.com NEXUS • 35 bacilli. Livingston stored away in her memory that this and Much5 held, as did L'Esperance, that it was caused by pathologist—Dr Elise L'Esperance—was probably right a peculiar form of tuberculosis, such as fowl tuberculosis, but would have a difficult time gaining acceptance for and debate over the infectious cause of Hodgkin's waxed her findings. the hottest of all the cancers. By 1931, L'Esperance was seeing "acid fast" Into this arena L'Esperance stepped in 1931, with few tuberculosis-like bacteria riddling her Hodgkin's cancer listening. Her article "Studies in Hodgkin's Disease" was tissue samples. That germ, once injected into guinea published in Annals of Surgery.6 It proved to be the one pigs, caused them to come down with Hodgkin's, too, legacy that no one, not even Ewing (who would soon die fulfilling Koch's postulates. She brought her stained from a self-diagnosed cancer), could take away. slides to former teacher and prominent Cornell cancer pathologist Dr James Ewing, "the father of oncology". He Dr Virginia Livingston and cancer's trUe caUse initially confirmed that her tissue slides indeed showed Our [cancer] cultures were scrutinized over and over again. Hodgkin's. But when he found out that her samples Strains were sent to many laboratories for identification. None came through guinea pig inoculation with fowl could really classify them. They were something unknown. tuberculosis which she had found in humans with They had many forms but they always grew up again to be the Hodgkin's, Ewing, visibly upset, said that the slide same thing no matter how they were cultured. They resembled samples then could not be cancer. the mycobacteria more than anything else. The tubercle bacillus This reaction betrayed his chequered history as a high- is a mycobacterium or fungoid bacillus. placed medical politician. In – Virginia Livingston, 19727 1907, you could have approached Dr James Ewing Virginia Wuerthele-Caspe about a cancer germ and he Livingston was born in 1906 in would have embraced you over By 1931, L'Esperance was Meadville, Pennsylvania, and it. Was it not Ewing who at one seeing "acid fast" went on to obtain impeccable time had proclaimed that credentials. Graduating from tuberculosis followed Hodgkin's tUbercUlosis-like bacteria Vassar College, she received her cancer "like a shadow"? riddling her Hodgkin's MD degree from New York But a few years later, Ewing University. The first female sent a sword through the heart cancer tissUe samples. medical resident ever in New of an infectious cause of cancer York City, in time Livingston with Neoplastic Diseases,2 becoming became a school physician in an ambitious zealot for radiation Newark, New Jersey, where one therapy with the directorship of what would one day day a staff nurse asked for medical assistance. become the Memorial Sloan–Kettering Cancer Center The nurse had already been diagnosed with Raynaud's squarely on his mind. His entry lay in the hands of syndrome: the tips of her fingers were ulcerated and bled prominent philanthropist James Douglas. A vote for intermittently. Livingston diagnosed scleroderma, but Ewing, Douglas knew, was a vote for continued radiation upon further examination she noticed a hole in the nasal and so Douglas began sizeable uranium extraction septum, something she had seen previously in the operations from Colorado mines through his company, mycobacterial diseases TB and leprosy. Phelps Dodge, Inc.3 So Livingston approached dermatologist Dr Eva Soon, Sloan's predecessor became known as a radium Brodkin and New Jersey pathologist Dr Roy Allen for hospital and went from an institution with a census of confirmation, all the while convinced that mycobacterial less than 15 per cent of cancer patients—separated by infection was causing the scleroderma. She then partition, lest their disease spread to others—to a performed cultures from a sterile nasal swab, and veritable cancer centre. But the very history of radiation mycobacteria appeared everywhere. When she injected revealed its flaws: by the early 1900s, nearly 100 cases of the mycobacteria into experimental chicks and guinea leukaemia had been documented in radium recipients, pigs, all but a couple died. During the autopsies, and not long thereafter it was determined that Livingston observed that the guinea pigs had indeed approximately 100 radiologists had contracted that developed the hardened skin patches of scleroderma... cancer due to radium exposure.4 Still, Ewing, by now an some of which were cancerous.8 honorary member of the American Radium Society, Livingston, now possessed, solicited fresh sterile persisted. specimens of cancer from any operating room that would Elise L'Esperance was anything but alone in linking give them to her. All cancer tissues yielded the same Hodgkin's to a germ called fowl tuberculosis. acid-fast mycobacteria. Allen confirmed her findings. Historically, Dr Carl Sternberg himself, co-discoverer of Livingston then found that she could actually Hodgkin's trademark Reed–Sternberg cell, believed that differentiate malignant from benign tissues by their Hodgkin's was caused by tuberculosis. Both Fraenkel tuberculous mycobacterial content.9 36 • NEXUS www.nexusmagazine.com DECEMBER 2009 – JANUARY 2010 But still the explanation for why the cancer germ tuberculosis that passed through a filter caused showed so many different forms was elusive. Hodgkin's cancer.10 This was subsequently supported in Virginia Livingston tried as she might, but part of her studies by Beinhauer, Mellon and Fisher.11, 12 Mellon problem in obtaining an American validation of her prophetically warned that tuberculosis could assume multi-shaped cancer germ lay firmly entrenched in the both its characteristic red acid-fast forms as well as its history of medicine, especially in the constantly changing blue nonacid-fast forms, indistinguishable from common field of microbiology. Louis Pasteur could handle being germs such as staphylococci, fungi and corynebacteria, quickly rushed off a Paris Academy of Sciences podium to and that this would surely perplex modern escape harsh reaction to his suggestion that children's microbiologists. milk be boiled first before drinking, but he could not When the American medical establishment chose to tolerate his rival Antoine Béchamp's statement that a ignore these studies, Alexander-Jackson warned that a so- single bacterium could assume many, many forms. called cure for TB could be short-lived, as classical TB However, on his deathbed, Pasteur apparently changed rods, for the moment gone underground as a nonacid- his mind when he said "The terrain is everything"— fast form, could resurface one day and spring back meaning that the culture or milieu which the bacteria towards destruction.